Premature Atrial Contractions Managed With Slow Pathway Ablation
We present data from 18 year old male patient referred to our clinic for evaluation and treatment due to persistent premature atrial contractions (PAC). Up to the time of admission, the patient never experienced paroxysmal tachycardia, and his principal complaint was the irregular heart rhythm refractory to all types of antiarrhytmic drug therapy. Electrophysiological study was performed and it revealed that continuous pacing in the right ventricle produced a retrograde conduction block at rates 500 msec. Decremental programmed electrical stimulation in the right atrium (S1S2 540/340 to 540/330 ms induced a sudden prolongation of A - H interval (AH jump of 98 ms) and a nonreentrant tachycardia (cycle length = 492 ms). Intracardiac electrogram showed that supraventricular activity emerged from simultaneous conduction over the slow and fast pathways of the atrioventricular node. This type of conduction is usually seen in patients with atrioventricular nodal reentry tachycardia, but our patient never previously complained of tachycardia, and the electrogram during tachycardia was not suggestive for atrioventricular nodal reentry tachycardia. Subsequent ablation of the slow pathway at the base of the Koch triangle yielded a cessation of the supraventricular premature activity, absence of the nonreentrant tachycardia and disappearance of the A-H jump.
Marica Pavkovic, Aleksandar Petlichkovski, Aleksandar Stojanovic, Dejan Trajkov and Mirko Spiroski
Bgl II Polymorhism of the α2β1 Integrin Gene in Macedonian Population
Background. Glycoprotein (GP) Ia/IIa or α2β1 integrin is a platelet receptor for collagen and it mediates platelet adhesion to vascular subendothelium and is involved in thromb formation. Genetic polymorphism of α2β1 known as Bgl II affects the density of platelet GP Ia/IIa receptor on the platelet surface. Recent studies had shown relationship between this polymorphism and the risk of myocardial infarction, stroke, as well as diabetic retinopathy.
Aim. The aim of this study was to determine the frequency of this polymorphism in Macedonian healthy population.
Materials and Methods. We genotyped 217 healthy Macedonian individuals using the PCR and RFLP (restriction fragment length polymorphism) method.
Results. The allele frequencies in this study were 0.32 for Bgl II (+) allele and 0.67 for Bgl II (-). Distribution of Bgl II genotypes in Macedonian population was Bgl II (+/+) = 16/217 (7.3%), Bgl II (+/-) =107/217 (49.3%) and Bgl II (-/-) = 94/217 (43.3%).
Conclusion. Our results showed a slightly lower proportion of the Bgl II (+) allele (0.32) in Macedonian population, but not significantly different from other Caucasian population.
Dejan Trajkov, Aleksandar Petlichkovski, Ana Strezova and Mirko Spiroski
Sixty Years Faculty of Medicine in the Republic of Macedonia (1947-2007)
Faculty of Medicine in Skopje, Republic of Macedonia was founded in 1947 year with its educational and health activities which should lead to improvement of the health care in the country. In the past sixty years Faculty of Medicine changed its structure, position, and the role several times in order to fulfill the needs of the society for continous increase of quantity and quality of tertiary health care, education of medical students, as well as research in the biomedical fields. Today, the organizational structure of the Medical Faculty consists of 12 institutes and 3 teaching bases in the pre-clinical department and 25 clinics, 3 institutes and 7 teaching bases which take active part in both, education and scientific activities. Altogether there are 33 departments which perform the entire educational (undergraduate, postgraduate, specialization and sub-specialization), scientific and providing health activities. These 33 departments are actively involved in the realization of the study programmes, not only at the Medical Faculty, but the Faculty of Stomatology, Pharmaceutical Faculty, the Faculty of Natural Sciences, and the Faculty of Physical Culture as well. Medical Faculty is a member of the European and the global family of institutions of this kind.
Aleksandar Petlichkovski, Dejan Trajkov, Ana Strezova and Mirko Spiroski
60. Years (1945-2005) Macedonian Medical Association
This year the monographic book "60 Years Macedonian Medical Association 1945-2005" was published, denoting more then six decades successful existence of Macedonian Medical Association (MMA). In the period behind us, the MMA has been bearer of the continuous development and growth of the health provision system. Starting its activities back in 1945, with only 123 doctors and dentists working in Republic of Macedonia, the MMA today represents more then 5000 doctors, of whom 3025 are specialists in various fields. The doctors in the MMA are organized into 22 regional or local associations and 70 specialist and sub-specialist associations. The MMA was the predecessor of the Faculty of Medicine in Macedonia, with the vast majority of the staff being recruited from MMA. A major contribution to the professional and scientific development of the medical profession in Macedonia was achieved through the introduction of the scientific journal and organization of scientific congresses under auspice of MMA. Today MMA is an active participant, initiator and consultant in the creation and improvement of the laws regulating the health service provision in the country. The highest state honour, the 11th October Award was awarded to MMA, as recognition for its continuous commitment to progress of Macedonian medicine.
Aneta Atanasovska-Stojanovska, Dejan Trajkov, Mirjana Popovska and Mirko Spiroski
Analysis of Transforming Growth Factor-Beta1 Gene Polymorphisms in Macedonian Patients with Chronic Periodontitis
Background. The existing conflicting data in the literature about the significance of TGF-beta1 polymorphisms in periodontitis.
Aim. To determine whether TGF-beta1 polymorphisms are associated with periodontitis in Macedonian population.
Material and methods. The sample consisted of 301 healthy unrelated individuals, and 132 patients with periodontitis. All individuals were of Macedonian origin and nationality and residents of different regions of the Republic of Macedonia. DNA was isolated from peripheral blood leukocytes by the phenol-chlorophorm extraction method. Cytokine polymorphism genotyping was performed by PCR-SSP (Heidelberg kit). The population genetics analysis package (PyPop) was used for analysis of the data. Crude odds ratios, were calculated with 95% confidence interval.P<0.05 was considered statistically significant.
Results. Significant negative (protective) association between the Macedonian patients with periodontitis and: 1) cytokine genotypes TGF-beta1 cdn 10/C:T and TGF-beta1 cdn 25/G:G; 2) cytokine haplotypes TGF-beta1/TG and cytokine haplotype zygotes TGF-beta1/CG:TG were found. Positive (susceptible) association was found with: 1) cytokine alleles TGF-beta1 cdn 10/C and TGF-beta1 cdn 25/C; 2) cytokine genotypes TGF-beta1 cdn 10/C:C and TGF-beta1 cdn 25/C:G; and 3) cytokine haplotypes TGF-beta1/CC and cytokine haplotype zygotes TGF-beta1/CC:CG.
Conclusion. It is concluded that polymorphisms of TGF-beta1 gene are associated with an increased risk of chronic periodontitis in Macedonian population.
Meri Kirijas, Slavica Hristomanova, Dejan Trajkov, Milanka Pajkovska, Berislav Kostov and Mirko Spiroski
Aim: To investigate the relation between the metabolic syndrome (MetS), and oxidized low density lipoprotein (ox-LDL) and non-high density lipoprotein cholesterol (non-HDL-C), and to evaluate a dietary therapy composed of a balanced hypocaloric regimen plus a supplement prepared from whole wheat and tigernut flour (Cyperus Esculentus).
Material and Methods: Forty two obese Egyptian female volunteers (their mean age was 47.76± 0.90) were given a low caloric balanced diet (900-1000 kcal) for 4 weeks, and then the supplement was used to replace Baladi bread during the next four weeks. The metabolic syndrome was diagnosed according to the International Diabetes Federation criteria.
Results: The prevalence rate of MetS was found to be 76.2%.The metabolic syndrome was significantly associated with higher levels of total cholesterol (T.cholesterol), LDL-C, ox-LDL and non HDL-C. Significant and sustained reduction in the levels of fasting blood glucose and HbA1c, normalization of lipid profile, and decrease in the levels of ox-LDL were observed after the end of the two periods of the dietary therapy.
Conclusion: Metabolic syndrome is associated with higher levels of circulating ox-LDL and non-HDLC. The use of the dietary therapy composed of balanced hypocaloric regimen plus a supplement rich in antioxidants and anti-inflammatory components, reduced obesity and the risky biochemical markers of the MetS.
Eli Djulejic, Aleksandar Senev, Meri Kirijas, Slavica Hristomanova, Aleksandar Petlichkovski, Dejan Trajkov and Mirko Spiroski
Allele Frequency of HLADQB1 Locus in Macedonian Population
Aim: The aim of this paper was to genotype HLA DQB1 locus in healthy unrelated Macedonian population.
Material and Methods: Reverse Line Strip typing for HLA DQB1 locus was performed on a population of 217 samples from healthy individuals. The results were obtained as alleles, and as NMDP Codes. Alleles were genotyped and expressed as high resolution with more than four digits with slash between ambiguous alleles. NMDP Codes were expressed as four digits for unambiguous results, and with combination of numbers and characters for the certain ambiguous combination. We did not found any genotypic ambiguities in HLA-DQB1.
Results: We have found 33 different alleles of HLA DQB1 in Macedonian population, 12 of which were unambiguous with the frequency of 40.55%, and 21 were ambiguous with the frequency of 58.53%. The biggest frequency (33.64%) was found for HLA DQB1*05 unambiguous groups, and for HLA DQB1*03 ambiguous groups (36.40%). The biggest allele frequency in Macedonian population for HLA DQB1 was found for HLA DQB1*03NX (0301/01/01/02/09/13) with 27.88%, followed with HLA DQB1*0502 with 13.82%, and HLA DQB1*02MN (0201/02/03) with 10.37%.
Conclusion: Allele frequency of HLA DQB1 in Macedonian population is similar with that found in other European populations and can be used for anthropology and disease association studies.
Slavica Hristomanova, Dejan Trajkov, Suzana Dinevska-Kjovkarovska, Aleksandar Petlichkovski, Slavcho Mitev and Mirko Spiroski
Influence of Hyperthermic Environmental Temperature on Adenosine Deaminase Activity in Serum and Lymphoid Organs of Wistar Rats
Aim: To analyze the influence of the hyperthermic environmental temperature (35 ± 1°C) on the adenosine deaminase activity (ADA) in tissues rich with lymphoid cells in Wistar rats.
Material and Methods: The activity of ADA was examined in thymus, spleen, Payer's patches, mesenteric lymph nodes and serum. The experimental animals (n = 11 male rats) were exposed on hyperthermic environment (35 ± 1°C) and relative air humidity of 20 - 30% within a period of 30 days. The control group of animals (n=10) were kept on room temperature (18 - 22°C).
Results: The body weight was decreased, spleen mass, and the thymus mass were reduced. Activity of ADA in the thymus was significantly increased from 10.58 ± 1.57 U/g in the control group of rats to 13.38 ± 2.7 U/g in rats exposed on 35 ± 1°C (p<0.01), and in the spleen it raised from 5.17 ± 3.29 E/g to 7.8 ± 1.97 U/g (p<0.05). The ADA activity in the other lymphoid organs and serum showed no statistically significant changes between the two groups of examined rats.
Conclusions: Influence of hyperthermic environment (35 ± 1°C, 30 days) provokes decrease in body weight, spleen and thymus relative mass, increase of the enzyme activity of ADA in thymus and spleen of rats, but there are no changes in the other lymphoid organs and tissues.
Aleksandar Petlichkovski, Sonja Peova, Dejan Trajkov, Todor Arsov, Ana Strezova, Slavica Hristomanova, Eli Djulejic, Jordan Petrov and Mirko Spiroski
Alpha-1-Antitrypsin Deficiency: A Case of a Two-year Old Boy with Inherited Disease
Alpha-1-antitrypsin (AAT) is a protease inhibitor which plays an important role of protector of the lung tissues against the proteolytic effect of elastase secreted from neutrophils. Its deficiency is associated with liver disease in children and emphysema in adults. So far, more than 75 variants of this protein are defined, but most of the cases of AAT deficiency are caused by homozygosis for the deficient allele PIZ or by heterozygous combination of the 2 most common deficient alleles, PIS and PIZ. A diagnosis in the case of a suspicion of AAT deficiency is carried out by measuring the alpha-1 antitrypsin level in blood and by genotyping the alpha-1 antitrypsin alleles. The importance of early diagnosis resides in the possibility of undergoing a lifestyle modification (such as vigorous smoking cessation, for example) and treatment of pulmonary disease thus significantly decreasing the morbidity. The family studying is important to identify individuals at high risk, and initiation of AAT replacement therapy in individuals. Having in mind the underdiagnosis of this disease, we hope to contribute with this case report to the medical community in Republic of Macedonia to raise the awareness of this disease, and also of the possibilities of exact diagnosis.
Dejan Trajkov, Aneta Atanasovska-Stojanovska, Aleksandar Petlichkovski, Ana Strezova, Jean Gogusev, Slavica Hristomanova, Eli Djulejic, Jordan Petrov and Mirko Spiroski
IL-1 Gene Cluster Polymorphisms in the Macedonian Population
The aim of this study was to genotype IL-1 gene cluster polymorphisms in the Macedonian population. A group composed of 301 healthy unrelated individuals was selected. IL-1 genotyping of the samples was performed by the PCR-SSP procedure followed by analysis of the IL-1 data with the PyPop population genetic analysis software package. The frequency of IL-1 alleles varies from 0.814 for IL1A -889/C, 0.729 for IL-1B +3962/C, 0.698 for IL-1RN mspa 11100/T, 0.671 for IL-1B -511/C, followed by 0.663 for IL-1R psti 1970/C indicating common "wild type" allele. We determined 27 different haplotypes from the total number of 32. The most frequent haplotypes for IL-1 are CCCCT (0.191), CTCCT (0.127), CCCTT (0.098), CCCCC (0.085), CTCTT (0.082). All pairs of loci for IL-1, except for IL-1R psti 1970, are in linkage disequilibrium, with p<0.05. The closest genetic distance is observed between the studied Macedonian population and the population from ItalyTorino, while the most genetically distant populations were TaiwanTsou, and TaiwanYami. It is concluded that IL-1 cluster alleles, genotypes, and haplotypes in Macedonian population show a good concordance with Hardy Weinberg equilibrium and can be used for anthropological comparisons, as well as for association studies with different diseases.